About the placebo effect

About the placebo effect

by andrea cortes on October 05, 2022 Categories: Blog

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Placebo is the name given to anything that may look like a real medical care but is not. Whether the treatment is a pill, an injection or any other type of placebo, the common denominator in these placebos is that they have no active ingredient that could affect your health. Its use is most common during the research phases, where it can help us understand how a new drug or treatment affects a particular condition.

The placebo effect has a rich history. It has an outsized role in the history of drug research when doctors were certainly offering useless drugs and potions to their patients. The first scientific demonstration of the placebo effect occurred as early as 1799, when a British doctor, John Haygrath, began evaluating one of the drugs then on sale, the expensive metal rods called Perkins tractors, which were supposed to remove disease from the body. He did this by comparing the fake, wooden metal bars with the real metal Perkins tractors, which looked just like the original ones available, and found that four out of five rheumatism patients had improved pain. He then published his findings on the Imagination as a Cause and as a Cure of Disorders of the Body.

Haygrath did not use the term placebo at that time, as the word had a different connotation at that time. The term was used later, in a 1921 article in The Lancet. It entered the clinical mainstream a few decades later, after the American anesthetist Henry K. Beecher saw that some of the wounded from battlefields in the Second World War had done well without morphine. It has since been found that placebo effects are strongest in conditions where feeling is key, such as pain, anxiety, or depression. At Beecher's urging, placebos have also been used in new ways in the modern scientific era, becoming a mainstay of double-blind clinical trials to shed lighter on their effects. The idea is that only a subset of participants in a trial receives the test substances, while the others receive a sham substance; no one knows who received what until the results are in and the trials are resolved. A drug can only be said to be successful if it is statistically significantly superior to a placebo. The fact that placebos can affect patients, both perceptually and symptomatically, which complicates the issue, means that the drug being tested must not only perform better than nothing, but must prove mind over body power best.

About the placebo effect

But a more important question is how does the placebo effect work? The answer is that we simply do not know. But there may be explanations, such as self-limiting illnesses like the common cold, which may resolve on their own, with or without placebo or actual drugs, or the cessation of symptoms being just a coincidence. We can also mention remission, as symptoms of certain disorders such as multiple sclerosis may appear and disappear. That is, remission during placebo treatment may also be a coincidence and is unlikely to be due to placebo. Another crucial factor may be a change in behavior, as the placebo increases the motivation to take better care of oneself, and better diet, regular exercise or more rest may help to alleviate symptoms. Anxiety may be reduced, and the hope of feeling better after taking a placebo can be reassuring, or the levels of stress chemicals such as adrenaline produced by the body may be reduced. Of course, a placebo may also have the effect that, after taking it, the body triggers its own natural painkillers, such as endorphins. I would also point out that research shows that the brain reacts to an imagined scene in much the same way as it would to an actual scene, so a placebo can help the brain remember the time before the symptoms and then trigger a change in the body, known as "remembered wellness".

There are a few things that can also help a placebo to work, including the characteristics of a placebo, because if the pill looks real, the person taking it is more likely to believe that it has an active drug. Research suggests that larger tablets suggest a stronger dose than smaller ones, so it may appear that taking two tablets is stronger than taking one. Similarly, placebo for injection has a greater effect than its tablet counterpart. The other persuasive argument that may help placebos work is the attitude of the person, because if the person is in the mindset that the treatment will be effective, then there is a greater chance of an effect. But the effect can work even if they are skeptical about it, this is where the power of suggestion comes in. Alternatively, the doctor-patient relationship is also a strong consideration, meaning that if the person trusts their health professional, then there is a high likelihood that the placebo effect will be effective.

About the placebo effect

However, there are also arguments against placebo, as well as unwanted side effects, such as nausea, drowsiness, allergic reactions such as skin rashes, also known as the negative placebo effect, also known as the nocebo effect. The other important counterargument is that deceiving people is not a nice thing to do, it is wrong, even if it is done with the intention of helping.

In a few words, I would mention the phenomenon known as the nocebo effect, which is a negative consequence that occurs because the patient expects to experience it. The nocebo effect can occur when a person is taking a real one, and it can also occur when they are given a placebo. These negative experiences may occur when the patient is told what adverse effects they may experience.

In summary, placebos have long been used in clinical trials, forming a major part of new treatment research. They can be used to test the effectiveness of a drug. Usually, one group takes the drug while another group, which is the control group, takes the placebo. There are cases where none of the participants knows whether the pill is active or inactive.

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Information complied by: Dezső Sándor.